Auscultation is defined as listening to the sounds made by various body structures as a diagnostic method. Auscultation can be used to listen to the patient's lungs, heart, intestines, and blood vessels in order to evaluate the frequency, intensity, duration, number and quality of sounds. Percussion is a diagnostic technique designed to determine the density of a body part by the sound produced by tapping the surface with the finger or a plessor. Percussion is usually performed over the chest in order to determine the presence of normal air content in the lungs and over the abdomen in order to evaluate air in the loops of the intestine and the size of solid organs, such as the liver and spleen. Percussion is also a form of massage consisting of repeated blows or taps of varying forces.
Good percussion technique can involve the hyperextension of the middle finger of a hand, known as the pleximeter finger. The distal interphalangeal joint is firmly pressed on the surface to be percussed. Surface contact should be avoided by any other part of the hand since other surface contact tends to dampen out vibrations. The forearm of the other arm is positioned close to the surface with the hand cocked upwardly. The middle finger should be partially flexed, relaxed and poised to strike. The pleximer finger is struck with the middle finger (or plexor finger) of the other hand with a quick, sharp, but relaxed, wrist motion. The aim is toward the distal interphalangeal joint. The strike occurs with the tip of the plexor finger and not the finger pad. The finger should be almost at a right angle to the pleximeter. The striking finger should be withdrawn quickly in order to avoid the vibrations created thereby.
Manual percussion has several disadvantages. In order to perform the percussion correctly, the examiner should have satisfactory coordination in order to apply a force to a location that is the thickness of a finger. Even when performed correctly, the sounds produced by percussion may not be clear to the examiner. Manual percussion may also become increasingly difficult to perform and less accurate when examining certain parts of the body, when examining from particular angles, or in the examination of obese patients.
Stethoscopes have various designs. In the medical field, stethoscopes traditionally have two sides on its head, a diaphragm side for high frequency sounds and bell side for low frequency sounds. Stethoscopes have also been designed so as to have both diaphragm and bell combined on one side. Currently, stethoscopes are used to auscultate a body. There are no stethoscopes that function effectively as percussion instruments.
Percussion devices also have various designs. Some percussion devices are as simple as a percussion hammer. Other percussion devices utilize sophisticated systems in order to produce sound that can be manipulated and monitored by way of a speaker. No percussion device has heretofore been contained within the head of a stethoscope.
U.S. Pat. No. 6,790,184, issued on Sep. 14, 2004 to J. S. Thierman, discloses a mechanical tapper that clips onto the end of the stethoscope. This mechanism has several disadvantages. Since it is an attachment, this device is not designed for simultaneous percussion and auscultation. As an attachment to the stethoscope, the percussion sounds obtained by the apparatus will refer to an area in the vicinity of the stethoscope and do not refer to the area below the center of the diaphragm of the stethoscope. The sounds produced by such a mechanism do not parallel those of manual percussion. In manual percussion, the examiner does not tap directly on the body, but rather the examiner taps on a finger that is firmly placed on the body to be examined. The tapper should not make contact directly with the body but rather should tap on some surface, such as rubber in order to mimic the examiner's fingers. This may not only produce inappropriate sound, but may also cause the patient discomfort by tapping directly on the body surface. The method of this patent does not disclose the technique whereby percussion sounds travel directly into the stethoscope. This attachment can only transmit sounds by way of the diaphragm. Since the methods in which the sounds are produced and transmitted are somewhat flawed, the examiner will not hear the same sound as heard during manual percussion. The attachment system mates with the head of the stethoscope and, as a result, the attachment may be inconvenient for both the examiner and the patient, especially when examining certain parts of the body. The attachment would not allow the examiner to percuss beyond certain angles since it is fixed on a 180° plane with respect to the diaphragm of the stethoscope. The apparatus of this patent does not disclose the use of a force that can be increased or decreased in order to accommodate different body wall thicknesses nor does it disclose a method of detachment wherein the device may be used separately as a percussion apparatus.
Various other U.S. patents have related to such diagnostic techniques. For example, U.S. Pat. No. 3,247,324, issued on Apr. 19, 1966 to R. Cefaly et al., teaches an acoustic and electronic stethoscope which includes a microphone and an amplifier for enhancing the receipt of acoustic signals from the human body.
U.S. Pat. No. 5,003,605, issued on Mar. 26, 1991 to Phillipps et al., discloses a stethoscope that simultaneously provides the listener with combined unmodified, familiar audible sounds along with sounds that have been electronically augmented to bring them within the human auditory range. A timing sound is provided along with the unmodified, familiar audible sounds and electronically augmented sounds in order to assist the listener in determining when sound occurs in the heart cycle.
U.S. Pat. No. 5,548,651, issued on Aug. 20, 1996 to H. F. Long, discloses a stereophonic stethoscope that utilizes binaural phase effect from two probes held in one chestpiece with an amplifier. The skin contacts in the probes are small in order to fit body curves and spread for wide pickup.
U.S. Pat. No. 5,960,089, issued on Sep. 8, 1999 to Bouricius et al., provides an ultrasound bell attachment for a stethoscope. The ultrasound bell includes an ultrasound transmitter for emitting ultrasound acoustic waves or signals and an ultrasound sound detector for receiving the reflected waves and converting these waves into electrical signals. The electronic circuitry within the ultrasound bell converts the electric signals created by the ultrasound detector into sound waves emitted by a speaker. The speaker is acoustically coupled to the turret of the acoustic stethoscope such that an airtight acoustic wave pathway is formed between the ultrasound bell and the turret of the stethoscope.
U.S. Pat. No. 6,485,434, issued Nov. 26, 2002 to Kahana et al., discloses an apparatus for acoustic percussion of a body. This apparatus has an oscillator circuit for creating electrical waves for exciting a loudspeaker and producing sound waves. A waveform shaping circuit shapes the electrical signals created by the oscillator into a waveform. A loudspeaker produces sound waves when excited by the electrical signals created by the oscillator. A potentiometer controls the tone produced by the oscillator and controls the volume of the sound.
U.S. Patent Publication No. 2002/0058889, published on May 16, 2002 to B. H. Lee, describes an automatic diagnostic apparatus with a stethoscope. In this device, the name of a disease is automatically determined and recorded based upon the auscultated sounds. The waveforms of the auscultated sounds from the stethoscope are converted into digital data and inputted into a computer. These digital data signals are compared with standard data that have been inputted into the computer in advance. As a result, a diagnosis of the disease is automatically provided.
German Patent No. DE004231629, published on May 13, 1993, discloses a method for analyzing the frequency characteristics of a heart. This method analyzes typical amplitude behavior with the percussion of the lungs for providing diagnosis through an audio/visual stethoscope.
It is an object of the present invention to provide an apparatus and method for providing simultaneous auscultation and percussion of a human or animal body.
It is still a further object of the present invention to provide a stethoscope apparatus that provides the examiner with the ability to auscultate and percuss simultaneously.
It is another object of the present invention to provide an apparatus which decreases physical examination time and provides increased comfort for the patient.
It is another object of the present invention to provide an apparatus which gives the examiner clear percussion sounds by way of the stethoscope.
It is still a further object of the present invention to provide an apparatus that allows percussion on the body to occur where manual percussion is difficult, inaccurate, unreliable or inefficient.
It is still a further object of the present invention to provide an apparatus which allows for percussion to occur from various angles of the body or in association with obese patients.
It is still another object of the present invention to provide an apparatus which provides simultaneous auscultation and percussion which is simple, reliable and cost-effective.
It is a further object of the present invention to provide an apparatus which allows for simultaneous auscultation and percussion in a device that has minimal moving parts and does not necessarily require an energy source to be operational.
These and other objects and advantages of the present invention will become apparent from a reading of the attached specification and appended claims.